HHS In-Person Assisters May Sell Door to Door

In a recent newsletter that goes out to exchange navigators and certified application counselors only, officials at the Centers for Medicare & Medicaid Services (CMS) discuss the rules that govern exchange assisters’ activities.

These rules apply directly to those assisters for the Affordable Care Act (ACA) exchanges run by the U.S. Department of Health and Human Services (HHS), the parent of CMS.  Some rules may also impact those assisters in state-based exchanges.

As a fresher, a certified Navigator (in-person assisters) provide unbiased information, at no cost, to help customers decide which health insurance option is best for them. Under the ACA, Navigators cannot recommend a specific plan to consumers.

HHS exchange assisters are not allowed to solicit door-to-door per sae.  The consumer must initiate or ask the assister to come into their home.   Once these terms are met, the in-person assister can sell exchange plans and services door-to-door, as long as they use a low-key approach.

More specifically, in an unsolicited visit, an assister can go door-to-door to educate consumers about the exchange system and the exchange application process.  Then, and only then, after the initial conversation with the consumer educating them about the exchange, if initiated by the consumer, the assister may at that time help with enrollment, the application process etc.

As more information becomes public we will continue to keep you up to date as this unfolds.  As always, we welcome your feedback and/or questions.  Please feel free to contact our government relations staff at BBochniak@michbusiness.org

Note: The CMS exchange helper newsletter is not readily available to the public.